Fast and Furious Health Care Reform

Published in Sohu
(China) on 19 June 2009
by 单士兵 (link to originallink to original)
Translated from by Guangyong Liang. Edited by Louis Standish.
The U.S. is undergoing its more expansive public health care reform in 40 years. It will cost a lot of money and will involve so many interests in order to provide medical coverage to 46,000 uninsured Americans. While the schedule to discuss the medical reform is ready, the U.S. Congress will officially begin to discuss plans on the 17th, striving to complete the legislation before the middle of October and get it signed by President Obama.

This means that it will only take four months from debating the reform to the end of passing the relevant legislation.

There is a tough and complicated resistance to U.S. health care reform. For example, the Democratic and Republican parties, the government and various interest groups are arguing over specific content which intertwines all kinds of interests. They even oppose President Obama’s hope to increase the status and effect of the government on medical insurance and to create new government insurance plans. They believe that will kill the private insurance business. However, all resistance will not block the rapid process of reform and resistance will not tie up the public accountability of the government.

Common sense tells us that all reforms must have a main body of compromise that can diminish specific resistance. Otherwise, reforms will be endlessly tangled up and will ultimately waste a lot of public resources and will lack respect from the public.

Therefore, I can’t help thinking of the ongoing marathon that is Chinese health care reform, which has been going on for such a long time with little to show for it. Any reform that the U.S. can do to health care that gets a compromise from all related parties will be a good template for us.





美国最近将开始进行一次40年来最大规模的医改。这次医疗改革牵动多方利益,耗资巨大,4600万没有医疗保险的美国人有望获得医保。这场改革日程的紧锣密鼓,美国国会定于17日开始正式讨论医疗改革方案,争取10月中旬前完成立法并交总统奥巴马签署。

这就意味着,从改革方法讨论到完成相关立法,美国竟然只需要4个月。
  实际上,美国医改同样有着艰难复杂的博弈。比如,美国民主党和共和党、政府和民间利益集团在具体内容上讨价还价,各种利益算计十分复杂。甚至, 连总统奥巴马希望增加政府在医疗保险中的地位和作用,创立一个新的政府医保方案,也遭到反对,认为那将会挤压民间保险机构的业务。但是,这一切的博弈却不 会阻挡住这场改革的快速进程,各方利益博弈也不会捆绑住政府的公共责任。
  常识早就告诉我们,所有的改革,都必然要求在利益博弈有妥协的主体,否则改革就会无休止地纠缠下去,最终造成公共资源的巨大浪费,也使民意得不到有效尊重。
  由此我不得不想起正在行进中的马拉松式的中国医改,时间拖了很久,效果依旧黯淡。美国医改、以及医改中各方对公共利益达成的妥协,实在是一面很好的镜子。
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